How to Choose an Adequate Health Insurance Cover?

Being referred to as the ‘Diabetes capital of the world’, the health of most Indians needs improvement. Combine this with growing medical inflation, and the cost of quality healthcare can be overwhelming, even for routine treatments. This makes having health insurance essential and no longer just a mere 'good option'.

Simply buying any health insurance plan is not enough. What matters is whether the coverage amount is truly adequate. You have to find an answer to—"Can it handle a real emergency without draining your savings?" 

So, let’s learn how to find the appropriate health insurance coverage that fits your needs, including personal, financial profile, and health risks.
 

It involves checking the reason for your decision to opt for health insurance cover. Is it pre-existing health conditions, family health, maternity and childbirth coverage or any other reason? Many financial advisors suggest choosing a cover amount that is several times your current annual salary (e.g., 5–6 times), but the actual requirement depends on your personal and family health needs. Subsequently, shortlist among the available plans that fit your criteria. Focus on the sum insured associated with the plan. Be mindful that a high amount will increase the premiums, while a low sum will not be enough to pay the bills.

Check for the Cashless Hospitalisation Benefit 

Cashless hospitalisation benefits refer to obtaining the most effective and quality medical treatment without paying the bill yourself. The insurance company must cover the bill. It is possible to choose an insurance service provider with a wide network of hospitals. Reading through the fine print and checking the list of covered cashless hospitals helps make the optimal choice. 

Consider the Waiting period.

It refers to the time you need to wait before raising a claim on the chosen policy. It is different for the variety of plans and insurance providers, and ranges from zero to several years. Depending on your and your family's health conditions, the appropriateness of this period will vary. Examine to find the low pre-existing disease-based waiting period while comparing the policies.

Avoid Co-payments

This feature requires the policyholder to pay a predetermined amount of the insured or covered sum themselves. It reduces the health insurance premiums. Again, the suitability of the feature will depend on your income and the stage of life you are in. Check for the presence of such a feature if you need, or the flexibility to opt out of it if you don’t need. Generally speaking, the co-payment adds to your out-of-pocket expenses, thus poorly influencing your finances. 

Check Claim Settlement Ratio 

The claim settlement ratio refers to the percentage of claims settled by the insurance provider compared to the claims raised in a year. The high ratio indicates the settlement of most claims, indicating a better quality of service. 

Conclusion 

Health insurance is a necessity nowadays, considering the poor lifestyle, diet and lack of exercise among individuals. With numerous options to choose from, the choices can be difficult to make. However, assessment of your needs helps you make clear choices. You must also consider other essential aspects that influence the cost incurred by you on medical treatments, such as coverage of the plan, exclusions, inclusions, waiting period, claim settlement ratio and others. Accordingly, make a decision that is specific and suitable for your needs.